Provider Demographics
NPI:1508155771
Name:MCCANTS, LATISHA L (LMHC, LIMHP, LMHC)
Entity Type:Individual
Prefix:
First Name:LATISHA
Middle Name:L
Last Name:MCCANTS
Suffix:
Gender:F
Credentials:LMHC, LIMHP, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:552 S CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:AVOCA
Mailing Address - State:IA
Mailing Address - Zip Code:51521-4044
Mailing Address - Country:US
Mailing Address - Phone:402-807-3969
Mailing Address - Fax:
Practice Address - Street 1:552 S CEDAR ST
Practice Address - Street 2:
Practice Address - City:AVOCA
Practice Address - State:IA
Practice Address - Zip Code:51521-4044
Practice Address - Country:US
Practice Address - Phone:402-968-2080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-28
Last Update Date:2024-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4880101YM0800X
NE1669101YM0800X
101YM0800X
IA001388101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health